Therapy for cardiac resynchronization: When left ventricular–only “fusion” pacing is not enough

Varma, Niraj

doi:10.1016/j.hrcr.2020.08.020

Cited by 1 publication

(1 citation statement)

References 5 publications

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“…However, transseptal delay in patients with LBBB where activation proceeds from the right bundle to the LV needs also be restored or mitigated via RV pacing. 32 As the LV activation is moved earlier (from 0 to 80 ms), a rightward frontal axis shift is observed in the ECG, from left/right superior to right inferior/superior with biventricular pacing. 33 There is also an activation As mentioned, the QRS complex during biventricular pacing most often has a dominant R wave in leads V1-2, suggestive of contribution from LV pacing.…”

Section: Effect Of Interventricular V-v Timing On the Ecg Of Biventricular Pacingmentioning

confidence: 94%

Electrocardiography of cardiac resynchronization therapy: Pitfalls and practical tips

Manolis¹,

Manolis

Manolis³

et al. 2021

Cardiovasc electrophysiol

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Cardiac resynchronization therapy (CRT) has been established as an effective mode of therapy in patients with heart failure and concurrent cardiac dyssynchrony, principally in the form of left bundle branch block (LBBB). The widespread use of CRT has ushered in a new landscape in 12-lead electrocardiography (ECG). ECG readings in these patients are most important to guide troubleshooting and also appropriate device programming, as well as discerning and managing nonresponders. A set of four ECG recordings need to accompany each patient with a CRT device, including a baseline ECG and recordings from monochamber (right and left ventricular) and biventricular pacing, which can be compared against a new recording to facilitate the evaluation of proper versus problematic biventricular pacing. Precordial ECG leads V1/2 acquired at the fourth intercostal space and limb leads, I and III, together with a quick assessment of perpendicular leads I and aVF to determine the quadrant of the QRS axis in the hexaxial diagram, may provide the framework for proper ECG interpretation in these patients. This important issue of 12lead ECG in CRT patients is herein reviewed, pitfalls are pointed out and practical tips are provided for ECG reading to help recognize and manage problems with CRT device function. Furthermore, several pertinent ECG recordings and tabulated data are provided, and an algorithm is suggested that integrates prior algorithms and relevant information from current literature.

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Section: Effect Of Interventricular V-v Timing On the Ecg Of Biventricular Pacingmentioning

confidence: 94%

Electrocardiography of cardiac resynchronization therapy: Pitfalls and practical tips

Manolis¹,

Manolis

Manolis³

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

Therapy for cardiac resynchronization: When left ventricular–only “fusion” pacing is not enough

Cited by 1 publication

References 5 publications

Electrocardiography of cardiac resynchronization therapy: Pitfalls and practical tips

Electrocardiography of cardiac resynchronization therapy: Pitfalls and practical tips

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